Provider Demographics
NPI:1144396292
Name:CARLSON-JONES, ERIN EILEEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:EILEEN
Last Name:CARLSON-JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:EILEEN
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12150 HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:BOULDER CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:95006
Mailing Address - Country:US
Mailing Address - Phone:408-893-9490
Mailing Address - Fax:
Practice Address - Street 1:1600 W. CAMPBELL AVE.
Practice Address - Street 2:SUITE 201
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95006
Practice Address - Country:US
Practice Address - Phone:408-871-4904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA617271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical